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Greece

Background
Greece offers a great variety of attractions for the international traveller. A beautiful climate linked with great beaches, a vibrant nightlife and historical monuments to rival any other location throughout the world. All of this located
within western Europe and a short flight away from many of the cooler northern destinations - like Ireland. Travellers from these regions descent on Greece in very significant numbers each year and for the vast majority of them they will have a splendid and healthy time. However for some this may not be the case and serious illness and accidents are regularly reported. Following some commonsense rules would go a long way to avoiding disaster and ensuring that this trip is truly one to be remembered for all the right reasons.
Climate
Situated in southern Europe the country enjoys mild winters but very hot summers. There may be occasional cool breezes (meltemia) but these can serve only to fool the traveller into thinking that they are unlikely to burn. Rain is very uncommon during the height of summer (July and August) and all travellers should be advised to use very adequate sun-block lotion at all times.
Slip, Slop, Slap
Following the Australian mantra of Slip, Slop and Slap makes perfect sense. Slip on a shirt, slop on sunscreen and slap on a hat when out and about during the day and this should help protect against the intense suns rays. Nevertheless, despite all their best intentions, travellers get burnt. This is particularly a problem in the first few days after their arrival when they do not realise the intensity of the suns rays and how easily they can be exposed. Falling asleep beside the hotel's swimming pool or on the beach is a very common problem and must be avoided against. The tips of the ears, shoulders (especially along the bra-strap line, ankles and behind the knees are commonly exposed and forgotten areas.
After Sun care
To treat significant sunburn it is important to increase fluid intake but also to take extra salt on your food (unless medically contraindicated for some specific condition like high blood pressure etc). Soothing water soluble lotions (especially ones containing a mild anaesthetic and/or steroid cream) are probably best but certainly avoid any of the ones which paste the skin with a thick layer - which is almost impossible to remove without causing serious pain! The more severe sunburn cases may need medical care and even hospitalisation which really ruins a holiday.
Food & Water
As a European destination Greece has a good level of food and water hygiene. Unfortunately this can vary - especially as you move away from the main tourist destinations and also as the summer temperatures rise and food goes 'off' more quickly. Eating hot food, avoiding cold foods (side-salads, lettuce etc) and never eating undercooked bivalve shellfish (mussels, oysters, clams etc) makes perfect sense. Eating food or taking fruit juice drinks from street vendors is a risk just not worth taking.
Insect bites
There may be both mosquitoes and sandflys about so having good repellents (DEET based ones) is worthwhile. The biggest problem will be early in the morning and towards the end of the daylight hours. However sitting in the shade while having lunch may be nice and cool but it is also often a place where these insects tend to hover looking for their next meal. Just don't allow that meal to be the blood in your unguarded ankle!
Seeing the Monuments
As mentioned previously Greece is covered with ancient monuments and these attract many thousands of tourists each year. The ruins are often not the most hospitable places for sun-sensitive tourists so taking care against the suns rays is essential - especially while standing carefully listening to the tour guide explain some complicated piece of history while the back of your legs get roasted! The other issue, for those trekking through the ruins, is the distinct possibility of a nasty twisted ankle.
Laser Night shows
Many of the ancient sites have beautiful night shows which depict something of the past splendour and are definitely worth seeing. However it is wise to wear good shoes as stumbling across loose stones is a particular problem at night and also bring a small torch, if possible, to guide your way. Getting separated from your travelling companions, or not being able to find your return bus, can lead to some understandable panic so listen carefully to any instructions and look out for some land marks before you get too far away into the night time crowd.
Animal bites
Some tourists may forget that rabies is a problem in many countries throughout the world and, even though Greece is regarded as rabies-free', there is always a problem if someone should get bitten. The possibility that this animal could have been recently smuggled into the country cannot be out ruled and so many would advise full post exposure treatment should this contact occur. Children may be at particular risk due to their inquisitive nature.
Swimming
Sunburn and swimming go hand in hand but drowning can also occur all too frequently within this region. Strong currents, swimming after meals (or alcohol) and the ever popular romantic midnight swim are all serious risk factors. Also children running around the deep end of the pool may lose their footing and topple in without warning. Unfortunately a very small child sinks instantly with very little sign of the emergency to those close by. Parents need to keep aware of this risk at all times.
The summer working holiday
Many of our students head towards Greece for 2 to 3 months during the summer to work. The attractions are obvious but commonsense and sensible life-style choices are needed throughout their stay to lessen the risk of illness or them returning home with an infection they had not bargained for. Unfortunately many return home with life-long illnesses which have been contracted from a single unprotected sexual contact.
Vaccinations for Greece
As a general rule the usual travel vaccines are not recommended for most short-term travellers to this region. However for the student planning to spend a more prolonged period it would be sensible to consider cover against both Hepatitis A and Hepatitis B and also to check that their Tetanus cover is up-to-date.
Summary
This is still one of the most popular destinations for northern European travellers and, in the vast majority of cases, they will have a fantastic time with only good memories. Unfortunately some less prepared folks will end up with serious sunburn and other illnesses or diseases which perhaps are frequently associated with their own lack of care and protection rather than anything specific to this beautiful country.

Travel News Headlines WORLD NEWS

Date: Tue, 7 Apr 2020 12:55:32 +0200 (METDST)

Athens, April 7, 2020 (AFP) - Hundreds of Greek healthcare workers demonstrated on Tuesday to protest at working conditions and lack of manpower and equipment in public hospitals during the coronavirus pandemic.   The demonstrations were staged to coincide with World Health Day, according to the federation of hospital personnel.   "You only saw us when we covered our faces," proclaimed a poster printed by hospital trade unions, bearing a picture of doctors wearing anti-coronavirus masks.    Demonstrators at the large Evangelismos hospital in central Athens held up signs demanding job hiring, virus testing and hospital equipment.

Police tried to enter the hospital courtyard where the rally was taking place before being forced back by demonstrators, an AFP photographer said.   A similar protest was held at the main hospital in Larissa in central Greece, according to images from public television ERT.    Despina Tossonidou, president of the doctors' union at Voula hospital in southern Athens, said that in addition to the hiring of medical staff, intensive care units in private clinics should be requisitioned "to overcome the shortcomings of the public sector" during the virus crisis.   Health care in Greece was drastically affected by the country's 2010-2018 financial crisis and tough austerity required by creditors in exchange for bailouts.

As part of its measures to deal with the pandemic, the government has offered clinics 30 million euros ($32.6 million) and announced the hiring on short-term contracts of 2,000 doctors and 2,000 nursing staff.    "These measures are just a drop in the ocean," said Tossonidou, a radiologist.    "The hospital system needs 30,000 additional permanent doctors," she said, also citing the lack of protective equipment and COVID-19 testing in hospitals.    "The majority of tests are currently carried out in private hospitals at costs ranging from 150 to 300 euros ($163-326)," said Tossonidou.    Greece, a country of around 10.7 million people, has suffered relatively less than other European nations in the pandemic, recording 81 deaths out of 1,755 cases.
Date: Sun, 22 Mar 2020 18:02:51 +0100 (MET)

Athens, March 22, 2020 (AFP) - Greece will impose a nationwide lockdown to stem the spread of the coronavirus, limiting people to their homes except for essential outings, Prime Minister Kyriakos Mitsotakis said Sunday.    "I have given orders that all appropriate action be taken to enforce the ban on all unnecessary movement across the country," Mitsotakis said in a televised address to the nation.   The restrictions will come into force from 6:00 am local time (0400 GMT) on Monday, and will require citizens to carry proof of identity to leave their homes. 

Outings are only permitted for people "going to work, the doctor, or to visit someone who needs help, or those who are buying food or medication", the prime minister said.    Citizens are also permitted to leave the house to walk their pets or exercise outdoors alone or with one other person.

There are 15 recorded deaths and 624 infections from the coronavirus in Greece, which has a population of 11 million.    Since reporting its first death from the virus on March 12, the country has gradually rolled out measures to limit gatherings and non-essential travel along with closing schools, shops and entertainment venues.
Date: Sat, 21 Mar 2020 10:59:18 +0100 (MET)

Athens, March 21, 2020 (AFP) - A strong 5.6 magnitude earthquake struck early Saturday in northwest Greece, damaging property in the city of Parga, authorities said.   The quake struck at 0049 GMT (0249 local time), with the epicentre 11 kilometres (around six miles) from Parga in Kanalaki district, and 316 kilometres northwest of Athens, the Athens geodynamic observatory said.   "No casualties have been reported at the moment," Parga mayor Nikolas Zacharias told AFP by telephone.

"Some old abandoned houses in Kanalaki collapsed and some houses suffered significant damage in this district of 2,500 inhabitants," Zaharias said, adding the temblor was strong throughout the area.   Landslides partially damaged the region's roads, he added.   Greece lies on major fault lines and is regularly hit by earthquakes, but they rarely cause casualties.   In 2017, a 6.7-magnitude earthquake killed two people on the island of Kos in the Aegean sea, causing significant damage.   In 1999, a 5.9-magnitude quake left 143 people dead in Athens and the region northwest of the capital.
Date: Wed, 26 Feb 2020 09:33:48 +0100 (MET)

Athens, Feb 26, 2020 (AFP) - Greece has announced a broad shutdown of public areas and travel restrictions, to be activated in case of a coronavirus outbreak.   The measures, formalised in a decree late on Tuesday, include temporary travel bans to and from countries with a large number of infections.

The decree also permits the requisitioning of beds in hotels and private clinics.   It also foresees the temporary closure of "indoor public gathering areas" such as schools, places of worship, cinemas, theatres, sports halls and businesses.   "We are ready to do whatever is necessary to protect public health," government spokesman Stelios Petsas told reporters.   The country has so far registered no confirmed cases of the virus.   Greece's health ministry has earmarked 13 hospitals nationwide equipped to handle virus cases.

A health ministry spokesman earlier this week noted that owing to the virus' long gestation period, health checks at ports and airports had minor chances of success.   On Monday, the Greek Olympic Committee said it had discussed alternative plans for the Olympic Flame lighting ceremony for the Tokyo 2020 Games in case of a virus outbreak.

The flame for the Tokyo 2020 Olympics is scheduled to be lit on March 12 in ancient Olympia and, following a torch relay on Greek soil, will be handed to the Tokyo organisers at a ceremony on March 19 at the Panathenaic Stadium in Athens.
Date: Tue, 18 Feb 2020 09:07:42 +0100 (MET)

Athens, Feb 18, 2020 (AFP) - Greece was hit with a 24-hour strike Tuesday over a pension reform encouraging people to stay longer in the workforce.   The labour action paralysed public transport in Athens, intercity trains and ferry ship services.   Civil servants are also walking off the job and journalists will stage a three-hour work stoppage against the pension reform.   "This bill is practically the continuation of (austerity) laws introduced in 2010-2019," civil servants' union ADEDY said.

Unions will hold street protests in Athens, Thessaloniki and other major cities later in the day.   The new conservative government says the reform, to be voted by Friday, will make the troubled Greek pension system viable to 2070.   The labour ministry says the overhaul -- the third major revamp in a decade -- will contain pension increases and reduce penalties for pensioners still working.

Successive governments have attempted to reform the pension system, whose previously generous handouts are seen as one of the causes of the decade-long Greek debt crisis.   Chronic overspending and the inaccurate reporting of the budget deficit spooked creditors in 2010, and required three successive bailouts by the European Union and the International Monetary Fund to avert a Greek bankruptcy.   In return for billions of euros in rescue funds, Greece had to adopt unpopular austerity reforms and pension cuts.
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Indonesia

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Information for Bali
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General
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Bali is one of the main tourist destinations for many Irish travellers to Indonesia. The island is well developed for the tourist industry and genera
ly the climate is tropical and humid throughout the year. Many Irish travellers will use the island as a stopover. If this is for only 24 to 28 hours the extent of your jetlag may leave you little time to enjoy the country and its people.
Safety & Security
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Throughout Indonesia there are many regions where it is unsafe to travel. The Parliament in Indonesia may impeach the President in the near future. Civil disturbance with student demonstrations in the capital Jakarta, earthquakes in the island of Sumatra, unrest regarding the independence of Timor and profound warring fractions on the island of Borneo has the potential to spill over into Bali. Nevertheless during the past years Bali has remained stable and there have been few reports of serious disturbances that have affected tourists or business travellers. Lombok is an island close to Bali often visited by tourists. It is regarded as more unstable and recently (Dec 2000) four explosions during fighting between two villages (Bongor & Parampuan). The main tourist region around Senggigi has remained quiet.

Local Customs
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The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
Night Activities
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The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
Medical Facilities
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The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
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It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
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Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
Sun Exposure
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The strength of the sun in Bali is considerable higher than that experienced in Ireland at any time of the year. Sufficient head covering should be worm when exposed and travellers should ensure that their fluid intake is sufficient. Salt depletion also needs to be replaced in times of significant perspiration.
Swimming
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If swimming in pools, make sure that sufficient chlorination has been used. Take care with small children when close to the deep end of the pool. If sea swimming make sure that there are always others around and that you heed any local advice and warning signs. Never swim soon after alcohol or for an hour after mealtime.
Jet Lag
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The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
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There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
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Poliomyelitis (childhood booster)
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Tetanus (childhood booster)
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Typhoid (food & water disease)
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Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
Summary
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The majority of those visiting Bali will enjoy the many tourist attractions on the island. However commonsense and care is required to ensure that you do not expose yourself to unnecessary risk. The staff of the Tropical Medical Bureau can be contacted at either of the numbers below if you require further information.

Travel News Headlines WORLD NEWS

Date: Tue, 31 Mar 2020 13:10:45 +0200 (METDST)

Jakarta, March 31, 2020 (AFP) - Indonesian leader Joko Widodo declared a state of emergency Tuesday as coronavirus deaths in the world's fourth most populous country jumped again, but he resisted calls for a nationwide lockdown.   Widodo's administration has been heavily criticised for not imposing lockdowns in major cities, including the capital Jakarta, a vast megalopolis home to about 30 million people where most of the country's virus deaths have been reported.

Indonesia's leader offered few details of the state of emergency beyond calling for stricter social distancing, but announced $1.5 billion in beefed-up social assistance and subsidies for low-income workers.   Tens of millions eke out a living on poorly-paid jobs in Southeast Asia's biggest economy.   "To overcome the impact of COVID-19, we've chosen the option of large-scale social distancing," Widodo told reporters.   "We must learn from the experience in other countries, but we cannot copy them because every country has its own characteristics," he added.

On Tuesday, authorities said 136 people had died after contracting the virus, with 1,528 confirmed cases of infection.   But the latter figure is widely thought to be well below the real number in the archipelago of more than 260 million.  The Indonesian Doctors' Association has warned that the coronavirus crisis is far worse than has been officially reported and that the government's response is "in tatters".

Jakarta's governor has said nearly 300 suspected or confirmed victims of the virus have been wrapped in plastic and quickly buried in the city since the start of March.   The capital's top politician has been pushing for a total lockdown of the city.   Also Tuesday, Indonesia's corrections agency said it is set to offer early release to about 30,000 inmates to help stem the spread of the virus in over-crowded prisons. The number amounts to more than 10 percent of Indonesia's 272,000 inmate population.
Date: Fri, 27 Mar 2020 11:53:09 +0100 (MET)

Jakarta, March 27, 2020 (AFP) - Indonesia's coronavirus crisis is far worse than being officially reported and the government's response is "in tatters", the country's doctors association warned Friday as the death toll climbed to 87.   The world's fourth-most populous country only reported its first confirmed infection this month but by Thursday, that had ballooned to over 1,000.

Indonesia's 87 confirmed coronavirus deaths are the highest toll in Southeast Asia, with public health and diplomatic officials warning that its weak health system is being rapidly overwhelmed.   "The government's plans are in tatters and they appear to be avoiding a lockdown," said Indonesian Doctors' Association spokesman Halik Malik.   "Our health system is not as strong as other countries."

A London School of Hygiene & Tropical Medicine study warned this week that cases in Indonesia -- with a population of more than 260 million people -- could be vastly underreported.   The government's virus task force has estimated as many as 700,000 people were at risk of infection nationwide.   But the rate of testing has been low compared with many other countries -- only 2,300 tests were conducted before the government stopped announcing nationwide figures.

Authorities have come under heavy criticism for not imposing lockdowns in major cities, including the capital Jakarta, a vast city home to about 30 million where most of the deaths have been reported.   "The COVID-19 situation in Indonesia is very serious and getting worse quickly," the Canadian embassy in Jakarta said Thursday, saying it was urgently advising citizens to leave.    "The health care system in Indonesia will soon be overwhelmed. The ultimate number of fatalities will be very high."   Indonesia had fewer than four doctors for every 10,000 people, according to World Health Organization data from 2017.

In comparison, neighbouring Malaysia had about 15 doctors and Australia had 35 per 10,000 people.   Images shared on social media have shown Indonesian doctors threatening to go on strike if resources aren't beefed up, with concerns about a lack of ventilators, protective gear and other equipment needed to handle coronavirus cases.   At least seven doctors have died of the virus, according to the official figures.

In a tweet that went viral, the brother-in-law of one of those doctors slammed the Indonesian government's handling of the crisis.   "You were infected as you actively served people. Many health workers have been infected and left. The limited amount of protective equipment is hard to forgive," wrote Pandu Riono, a University of Indonesia public health expert.   The government has pledged to boost testing to upwards of one million checks as extra equipment and test kits are flown in from China.   It has also turned an athletes village built for the 2018 Asian Games into an emergency treatment centre to help ease the pressure on hospitals.
Date: Fri, 27 Mar 2020 09:24:46 +0100 (MET)

Jakarta, March 27, 2020 (AFP) - Indonesia's most active volcano Mount Merapi erupted Friday, shooting a column of ash some 5,000 metres (16,000 feet) into the air in its second major eruption this month.   Ash and sand covered areas several kilometres (miles) away from the peak of the rumbling crater near Indonesia's cultural capital Yogyakarta.   But authorities did not raise Merapi's alert level.   "There has been no reports of damage from the  eruption. We urge people to stay calm and not panic," national disaster mitigation agency spokesman Agus Wibowo said.   Merapi erupted earlier this month, shooting a massive ash cloud some 6,000 metres in the air.    That eruption coated Yogyakarta and neighbouring city Solo with grey dust and forced an airport closure.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of 280,000 residents.  That was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.    The Southeast Asian nation -- an archipelago of more than 17,000 islands and islets -- has nearly 130 active volcanoes.    It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity
Date: Tue, 3 Mar 2020 05:53:04 +0100 (MET)

Solo, Indonesia, March 3, 2020 (AFP) - Indonesia's most active volcano Mount Merapi erupted Tuesday, shooting a massive ash cloud some 6,000 metres (20,000 feet) in the air which coated nearby communities with grey dust and forced an airport closure.   Ash mixed with sand rained down on towns as far as 10 kilometres (six miles) from the belching crater near Indonesia's cultural capital Yogyakarta.   "There was a thundering noise for at least five minutes and I could see the ash clouds from my house," Jarmaji, a resident of Boyolali regency, told AFP.

Authorities did not raise the rumbling volcano's alert status, but they temporarily shuttered the international airport in Solo city -- also known as Surakarta -- some 40 kilometres away after the early morning eruption.   Indonesia's volcano agency warned residents to stay out of a three-kilometre no-go zone around Mount Merapi, citing possible danger from flowing lava and pyroclastic flows -- a fast-moving mixture of hot gas and volcanic material.

Mount Merapi's last major eruption in 2010 killed more than 300 people and forced the evacuation of some 280,000 residents.   That was Merapi's most powerful eruption since 1930, which killed around 1,300 people, while another explosion in 1994 took about 60 lives.   The Southeast Asian nation -- an archipelago of more than 17,000 islands and islets -- has nearly 130 active volcanoes.   It sits on the Pacific "Ring of Fire", a vast zone of geological instability where the collision of tectonic plates causes frequent quakes and major volcanic activity.
Date: Mon, 2 Mar 2020 08:33:07 +0100 (MET)
By Peter BRIEGER, Agnes ANYA

Denpasar, Indonesia, March 2, 2020 (AFP) - Bali's Galungan festival celebrates the triumph of good over evil, but a new enemy was threatening that cosmic balance this year -- coronavirus.   Temples across the Island of the Gods were filled with faithful who hoped incense-and-flower offerings would get Hindu-majority Bali back on its feet after a drastic slump in Chinese visitors hammered the key tourism sector.  "We're praying for good things in this universe and that the virus is gone soon so Bali's tourism can bounce back," priest Made Langgeng Buwana told AFP during the recent February Galungan celebration in the capital Denpasar.

Concerns over the rapidly-spreading outbreak prompted Indonesia to shut down all flights to and from China last month, dealing a body blow to scores of Bali businesses including restaurants, hotels, travel agents, wedding planners and Mandarin-speaking interpreters. Around a million Chinese tourists visit the holiday island each year -- the second-largest group of foreign arrivals after Australians -- and inject hundreds of millions of dollars into the local economy.    Thousands travelled there from the mainland for last month's Lunar New Year holiday just as the virus outbreak was beginning to snowball, prompting the lockdown of China's Hubei province where the infection was first detected.

- Ghost town? -
In Bali, some China-focused businesses have closed and others say they're on the brink of bankruptcy.   Management at one upscale hotel was so desperate to cut costs they told employees to wear street clothes on the job to reduce uniform cleaning expenses, according to staff.

Bali's tourism industry has suffered -- and recovered -- before, including when volcano Mount Agung erupted in 2018.   "There was a drop then but not something like this," said Robin, 29, an Indonesian interpreter who used to guide wealthy Chinese around the island.   Jakarta has announced more than $700 million in stimulus to bolster
Southeast Asia's biggest economy as its tourism sector takes a hit, while Bali officials hope social media influencers can help draw more visitors.

The island's tourism agency head Putu Astawa -- barely two months into his new job -- acknowledged that losing 100,000 Chinese visitors a month has stung.   But the number of visitors from Australia, Japan, North America and Europe is stable, despite unfounded reports that Bali is a ghost town, he insisted.   "I don't worry about the virus," Astawa said in an interview.   "I worry about social media hoaxes hurting the image of our tourism sector. I'm tired of fighting it."

- 'Fatally impacted' -
The ghost-town image isn't fake news at Dream Island Bali Beach Club, however.   Chinese tourists used to roll in for wedding photos, massages in thatched huts, beachside camel rides and a $17 'Dream Dinner' package with a fire-dance show.   The now-empty operation also ferried mainly Chinese visitors on boats to company-run restaurants nearby.

Those eateries are now closed, the ferries are beached and Dream Island is headed for bankruptcy with half the staff on leave, said manager Wayan Tirta.   "Now we're trying to get local students to come here because there aren't any tourists," he said, plunging his hand downward to show the drop in business.   "We've been fatally impacted by the outbreak and are just trying to stay afloat."   At Dream Island's deserted Mermaid Bay restaurant, Arik and two other staff played with their smartphones as a pair of unemployed camels lay in the sand nearby.   "We don't have anything to do. Hopefully we'll get some more guests," she said.

In Denpasar, OYO 1992 China Town Hotel -- draped in bilingual signage and a huge lobby painting of a woman with a Chinese-style fan --  is also feeling the pinch.   The hotel once employed scores of massage therapists who relied on mainland tourists, but that crucial moneymaker has dried up.   "Before coronavirus we were planning to add more massage beds," said manager Vincent Fonda in the hotel's empty Chinese food restaurant.   "At the end of the day, we're probably going to close down."
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Niue

No Profile is available at present

Travel News Headlines WORLD NEWS

20th July 2012

- Niue Island. 20 Jul 2012. Two tourists visiting Niue have been taken to hospital with dengue fever. More than 100 people, or about 8 percent of the population, are believed to be suffering from the fever, and visitors are being warned to use insect repellent during early morning and evening. Dengue, which does not often occur on Niue, has been afflicting  the island since February [2012]. It was originally confined to a small area of Niue's main village but has now spread throughout the island. One local man recently died from a serious form of the virus.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific Ocean can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 30th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 24 Apr 2012. The Niue Health Department says it believes the dengue outbreak has peaked. The department says there have been 47 recorded cases of dengue fever, but only one case has been picked up in the last 7 days. The Acting Director of Health, Manila Nosa, says it's a relief to see the wane in cases, but it's too early to say that dengue is completely gone. He said that there has been a lot of rain lately, and it's hoped this won't contribute to a further spread.
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[A HealthMap/ProMED-mail interactive map of Niue Island can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Monday 16th April 2012
A ProMED-mail post
<http://www.promedmail.org>

- Niue Island. 12 Apr 2012. Health authorities on Niue are confident that they are on top of the latest dengue outbreak that has infected 20 people to date. The chief medical officer, Dr Eddie Akau'ola, says this outbreak began about 3 weeks ago but they believe they have been able to contain it. He says it is peaking now and they expect a decline in a week or 2. Dr Akau'ola says none of the cases have been too serious.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/2bMz>. - ProMed Mod.TY]
Tuesday 13th March 2012
A ProMED-mail post
<http://www.promedmail.org/>

- Niue Island. 6 Mar 2012. Niue health authorities are hopeful they've contained a rare outbreak of dengue fever on the island where 3 people were reported with dengue last week, with 2 admitted to hospital.
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[A HealthMap/ProMED-mail interactive map showing the location of Niue Island in the Pacific can be accessed at <http://healthmap.org/r/1ZWb>. - ProMed Mod.TY]
Date: Sun, 24 Jul 2011 10:42:49 +0200 (METDST)
by Neil Sands

ALOFI, Niue, July 23, 2011 (AFP) - In a once-thriving village on the Pacific island of Niue, homes lie abandoned, their stucco-clad walls mildewed and crumbling as the jungle slowly reclaims them. "These villages used to be bustling with people -- now you go there in the afternoon and there's no one," says the Niue Tourism Authority chairman Hima Douglas. The number of people living on the lush coral atoll, about 2,500 kilometres (1,550 miles) northeast of New Zealand, has been declining for decades as inhabitants seek a better life overseas.

The population, which peaked at more than 5,000 in the mid-1960s, has dwindled to just 1,200, according to a New Zealand parliamentary report, raising doubts about the island nation's economic viability.  Douglas said a major cyclone in 2004, which destroyed much of Niue's infrastructure, accelerated the exodus, and the threat of future natural disasters was discouraging people from returning. "Of course it's concerning but it's not something we can do too much about until we can build an economy that will give them the confidence to come back," Niue's Premier Toke Talagi told reporters this month. "There aren't simple and easy answers to people leaving. We've got to build a strong economy and hope to attract them back." Known locally as "The Rock", Niue was settled by Polynesian seafarers more than 1,000 years ago and the palm-dotted island's name in the local language means "behold, the coconut".

The British explorer captain James Cook tried to land there three times in 1774 but was deterred by fearsome warriors, eventually giving up to set sail for more welcoming shores and naming Niue "savage island" on his charts. But modern day Niueans are desperate for visitors, with Talagi unveiling plans this month to turn it into a boutique tourism destination in a bid to put his nation on a sound economic footing. Using aid from New Zealand, with which Niue has a compact of free association giving its people dual citizenship, Talagi has overseen construction of a new tourism centre and expansion of the island's Matavai Resort.

Paths have also been cut through the jungle to give visitors access to swimming spots on the rugged limestone coastline, and cruise liners are being encouraged to include Niue on their itineraries. "We can become self-sustaining in the long term (and) reduce New Zealand assistance to Niue," Talagi said, estimating that visitor numbers could quadruple to 20,000 a year in the next decade. Addressing a visiting delegation of New Zealand business executives this month, Talagi acknowledged doubts about the nation's ability to meet the challenge. "I know some of you are a bit sceptical about our ability to become self sustaining... (but) tourism is not going to fail and I don't expect it to fail given the numbers that are being generated," he said.

The New Zealand parliamentary report, released last December, estimates that about 50,000 Niueans and their children now live in Australia and New Zealand, creating a shortage of skilled labour in one of the world's smallest states. "Niue is caught in a vicious cycle, with its economic difficulties both exacerbated by, and reflected in, the long-term decline of its population," it said, adding that 40 years of New Zealand aid "has yielded almost no return". The report's authors suggested Niue should concentrate on promoting itself as a retirement destination for elderly New Zealanders, who could help revitalise the economy. "The climate is excellent, existing buildings could be brought into service, and health facilities are satisfactory," it said. "Retirees would bring steady cash flow and contribute to stable employment options."

Asked about the suggestion, Talangi said "we'll look at everything", although one long-time resident, who asked not to be named, was unenthusiastic at the prospect. "How depressing to think that we might be turned into a major geriatric ward," she said. "Not that I have anything against old people, mind." Another resident said that whatever steps Niue took to improve its economy must result in major changes, pointing out people could earn more by moving to New Zealand and claiming unemployment benefits than working on the island. "It's pretty hard when your cuzzies (cousins) call you and say 'we're getting more on the dole in Auckland than you're getting paid'," he said.
More ...

Qatar

Qatar - US Consular Information Sheet
February 26, 2008
COUNTRY DESCRIPTION:
Qatar is a monarchy governed by the ruling Al Thani family in consultation with a council of ministers, an appointed advisory council and an elected municipal cou
cil.
Islamic ideals and beliefs provide the foundation of the country’s customs, laws and practices.
Located in the heart of the Persian Gulf, Qatar is a dynamic, modernizing, rapidly developing country that is among the wealthiest per capita in the world.
The capital is Doha.
Tourist facilities are available.
Read the Department of State Background Notes on Qatar for additional information.
ENTRY/EXIT REQUIREMENTS:
Passports and visas are required.
U.S. citizens may obtain a single-entry tourist or business visa at Doha International Airport upon arrival.
Single entry visas cost $28 and must be paid by credit card only.
Cash is not accepted.
Visas are valid for 30 days and may be extended for an additional 30 days for a $28 fee through the Airport Visas Section of the Immigration Department located next to Doha International Airport.
However, U.S.-citizen travelers will be able to clear Qatari immigration more quickly and be granted a longer stay in country by obtaining visas prior to arrival.
If planning to arrive at another port of entry in Qatar, travelers should obtain a tourist or business visa in advance of their arrival from a Qatari embassy or consulate abroad.
Travelers should also note that the Qatari Government charges $55 for each day that an individual overstays a visa, up to a maximum amount of $3,300.

For further information on visas, residence permits and entry requirements, please visit the Qatari Ministry of Interior’s web site at www.moi.gov.qa/English/index.htm.
Travelers may also contact the Embassy of the State of Qatar (www.qatarembassy.net) at 2555 M Street NW, Washington, DC
20037, tel. (202) 274-1600, fax (202) 237-0061.
They may also contact the Consulate General of the State of Qatar, 1990 Post Oak Blvd. Suite 810, Houston TX 77056, telephone (713) 355-8221, fax (713) 355-8184, send email inquiries to info@qatarembassy.org.

Military personnel are subject to different entry/exit requirements and should refer to www.fcg.pentagon.mil for specific information pertaining to their travel requirements.
NOTE FOR DUAL NATIONALS:
Qatari law requires that Qatari citizens only hold Qatari citizenship and enter and exit on a Qatari passport.
Qatari authorities have confiscated the passports of U.S. citizens who acquired Qatari citizenship through marriage to a Qatari national or by virtue of birth in the U.S.
In several cases, Qatari authorities informed U.S. citizens that their U.S. citizenship had been revoked and was no longer valid.
However, foreign governments have no authority to revoke the citizenship of a U.S. citizen.
If this occurs, please contact the U.S. Embassy in Doha immediately.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Incidents of violence are rare in Qatar, although attacks against Western targets have occurred.
To provide for public security, a large police presence is deployed throughout the country.
American citizens in Qatar are strongly encouraged to maintain a high level of vigilance, be aware of local events and take the appropriate steps to bolster their personal security at all times.

The Department of State remains concerned about the possibility of terrorist attacks against U.S. interests worldwide, including the Middle East.
Both historical and recurring information suggests that al-Qa’ida and affiliated organizations continue to plan strikes against Western targets; these attacks may employ a wide variety of tactics to include assassination, kidnapping, hijacking and bombing.
On March 19, 2005, a suicide bomber detonated a vehicle-borne improvised explosive device (VBIED) at a theater in Doha regularly frequented by westerners; a citizen of the United Kingdom was killed, and several other individuals were injured.

Increased security at official facilities has led terrorists and their sympathizers to seek softer, less fortified targets; the March 2005 theater attack in Doha is one such example.
Other locations of potential concern include any venue where U.S. citizens and other foreigners are known to congregate in large numbers such as public assemblies, sporting events, restaurants, residential areas, clubs, places of worship, schools, hotels, etc.
The Government of Qatar occasionally provides security for such locations and events, but to varying degrees.
In most instances, the Embassy cannot gauge the appropriateness of security for a given event prior to its commencement.
The Embassy strongly encourages American citizens to avoid large crowds and demonstrations whenever possible.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s Internet web site, where the current Worldwide Caution, Travel Warnings and other Travel Alerts and additional resources can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada or, for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
The crime rate in Qatar is generally low.
A large police presence is apparent to travelers throughout the country.
Incidents of violence are rare but have occurred more frequently as Doha’s population and economic pressures on expatriate workers have increased substantially during the past few years.
Local and third country national young men have been known to verbally and physically harass unaccompanied, expatriate women.
Reports of petty theft have been growing, including ATM and credit card theft, purse snatching and pickpocketing.
Travelers are cautioned not to leave valuables such as cash, jewelry, and electronic items unsecured in hotel rooms or unattended in public places.

The Qatari Police can be contacted for emergency assistance by dialing 999 from any telephone in Qatar.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy in Doha.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance.
The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Good modern medical care and medicines are available in Doha, although only basic or no medical care may be available in Qatar’s smaller cities or outlying areas.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.
Doctors and hospitals expect immediate cash payment for health services.
Information about the Qatari national healthcare system is available at http://www.hmc.org.qa.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Qatar is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Short-term visitors should obtain a valid International Driving Permit prior to arrival and should not drive in Qatar on a U.S. driver’s license.
Short-term visitors and business travelers can also obtain a Temporary Qatari Driving License by presenting their U.S. driver’s license at any branch of Qatar’s Traffic Police.
New and prospective residents should obtain a permanent Qatari Driving License immediately after arrival.
Once an American citizen holds a valid Qatari residence permit, they are no longer permitted to drive in Qatar with an International Driving Permit or a Temporary Qatar Driving License.

Traffic accidents are among Qatar’s leading causes of death.
Safety regulations in Qatar are improving thanks to a more stringent traffic law adopted in October 2007 and a country-wide traffic safety campaign.
However, informal rules of the road and the combination of local and third-country-national driving customs often prove frustrating for first-time drivers in Qatar.
The combination of Qatar’s extensive use of roundabouts, many road construction projects and the high speeds at which drivers may travel can prove challenging.
The rate of automobile accidents due to driver error and excessive speed is declining but remains higher than in the United States.
In rural areas, poor lighting, wandering camels and un-shouldered roads are other hazards.
Despite aggressive driving on Qatar’s roads, drivers should avoid altercations or arguments over traffic incidents, particularly with Qatari citizens who, if insulted, have filed complaints with local police that resulted in the arrest and overnight detention of U.S. citizens.
Drivers can be held liable for injuries to other persons involved in a vehicular accident, and local police have detained U.S. citizens overnight until the extent of the person’s injuries were known.
Due to its conservative Islamic norms, Qatar maintains a zero-tolerance policy against drinking and driving.
Qatar’s Traffic Police have arrested Americans for driving after consuming amounts of alcohol at even smaller levels normally accepted in the U.S.
Any motor vehicle over five years old cannot be imported into the country.
For specific information concerning Qatari driver’s permits, vehicle inspection, road tax and mandatory insurance, please contact either the Embassy of the State of Qatar in Washington, DC or the Consulate General of the State of Qatar in Houston, Texas.
Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Qatar’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Qatar’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Qatari customs authorities enforce strict regulations concerning importation into Qatar of items such as alcohol, narcotics, pork products, firearms, or anything deemed pornographic by Qatari authorities.
While importation of religious material for personal use is acceptable, importation of religious material for the purpose of proselytizing is not.
It is advisable to contact the Embassy of the State of Qatar in Washington, DC, or the Consulate General of the State of Qatar in Houston for specific information regarding customs requirements.

Please see our Customs Information.

Pets entering Qatar require an import permit from the Ministry of Agriculture.
Cats with proper documentation are allowed to enter with no difficulty, but some breeds of dogs, especially large dogs, are not admitted.
Application forms for import permits may be obtained from the Ministry of Agriculture through a sponsoring employer.
A copy of the pet's health certificate and vaccination record must be submitted with the application.

Qatari law does not recognize dual nationality.
Persons who possess Qatari citizenship in addition to U.S. citizenship are considered Qatari citizens by the State of Qatar and are subject to Qatar’s laws.
Qatari citizenship imposes special obligations, particularly with regard to child custody and exiting or entering the country.
For additional information, please refer to our dual nationality flyer
or contact the U.S. Embassy in Doha.

All U.S. citizens are encouraged to carry a copy of their passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
Qatari employers/sponsors customarily hold passports of foreign (i.e., non-Qatari) employees during the terms of their employment in Qatar.
Residents carry a Qatari Identification Card (Iqama) for identification in place of a passport.
Foreign nationals, including U.S. citizens, may not leave Qatar without permission in the form of exit visas obtained by their employer/sponsor.
The U.S. Embassy in Doha cannot assist U.S. citizens in Qatar to obtain third country visas for unofficial travel.
Islam provides the foundation of Qatar’s customs, laws and practices.
Foreign visitors are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts.
Western bathing attire is worn at hotel pools and beaches.
BUSINESS AND EMPLOYMENT CONTRACTS:
The written, Arabic text of a contract governs employment and business arrangements under Qatari law.
Before signing a contract, U.S. citizens and companies should obtain an independent English translation of the original Arabic to ensure a full understanding of the contract's terms, limits, and agreements.
No U.S. citizen should work in Qatar or make a business arrangement without having seen and understood the full, written contract.
Verbal assurances or side letters are not binding in Qatar.

In the event of a contract or employment dispute, Qatari authorities refer to the Arabic language of a contract.
Since a Qatari sponsor holds the employee's passport and controls the issuance of exit visas, U.S. citizens cannot simply leave Qatar in the event of an employment or business dispute.
Any U.S. citizen who breaks an employment or business contract may have to pay substantial penalties before being allowed to depart Qatar.
Qatari law favors employers over employees, and Qatari sponsors have substantial leverage in any negotiations and may block the departure of the employee or bar future employment in Qatar.

Transferring employment in Qatar requires the permission of the previous employer, which is discretionary, and is subject to approval by the Ministry of the Interior.
The Ministry of the Interior has denied employment transfers in the past, including ordering U.S. citizens deported and barred from re-entry to Qatar for two years.
The U.S. Embassy has no standing in Qatar’s courts, cannot sponsor visas, and cannot adjudicate labor or business disputes.
U.S. consular officers can provide lists of local attorneys to help U.S. citizens settle disputes, but ultimate responsibility for the resolution of disputes through Qatar’s legal system lies with the parties involved.
To obtain a residence permit in Qatar, the Government of Qatar usually requires foreign citizens to provide a police clearance certificate from their home countries.
Prospective residents can obtain a U.S. police clearance certificate two ways: through a local or state law enforcement agency or through the Federal Bureau of Investigations (FBI).
In both cases, the clearance will run against the National Crime Information Center, which contains all federal, state and local criminal records.
This process requires several weeks, and the U.S. Embassy in Doha strongly recommends that prospective residents obtain a U.S. police clearance before they arrive in Qatar.

For more information on business opportunities and practices in Qatar, please visit the Foreign Commercial Service’s Country Commercial Guide for Qatar at http://www.buyusa.gov/qatar.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Criminal offenses are punished according to Qatari laws, which in some cases are based on Islamic law and sometimes more severe than in the United States for similar offenses.
Persons violating Qatari laws, even unknowingly, may be arrested, imprisoned, deported, or subject to a ban from departing Qatar.
Travel bans are not lifted until both parties resolve a dispute and the case is abandoned or, if not, until the matter is resolved by a court, which may require months to process the case.
Qatari law enforcement authorities have detained potential witnesses or relatives without charges or access to legal counsel during the investigation of a crime.
The U.S. Embassy in Doha cautions American citizens that Qatari police can and have arrested American citizens suspected of or witness to a crime, including traffic accidents involving injuries to pedestrians or the occupants of other cars, traffic arguments, slander, and a variety of lesser offenses.
Once arrested, the Qatari Police have no independent authority to grant a release, an authority reserved solely for Qatar’s Public Prosecution and Courts.
As a result, arrested Americans, regardless of the charges, often spend one night in jail awaiting a hearing with Qatar’s Public Prosecution or the appropriate court.
Qatari law enforcement authorities do not routinely notify the U.S. Embassy in Doha of a U.S. citizen’s arrest and, for more serious crimes, may not allow a U.S. Embassy official to visit an arrested U.S. citizen until the initial interrogation is completed.
Upon arrest, U.S. citizens should ask to speak to the U.S. Embassy immediately, and if not allowed, request a friend or family member notify the U.S. Embassy through the contact information below.
Incidents involving insults or obscene language/gestures often result in arrest, overnight imprisonment and/or fines whether the incident occurs between private parties or involves officers of the law.
Drunk driving, public intoxication and other alcohol-related offenses are treated with severity and will result in arrest, heavy fines, imprisonment, or expulsion from the country.
Penalties for possession, use, or trafficking in illegal drugs in Qatar are severe, and convicted offenders can expect long jail sentences and heavy fines.
Homosexual activity is considered to be a criminal offense, and those convicted may be sentenced to lashing and/or a prison sentence, and/or deportation.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Qatar are encouraged to register with the U.S. Embassy in Doha through the State Department’s travel registration web site to obtain updated information on travel and security within Qatar.
Americans without Internet access may register directly with the U.S. Embassy in Doha.
By registering, American citizens make it easier for the U.S. Embassy in Doha to contact them in case of emergency.
The U.S. Embassy is located in the Al-Luqta District on 22nd February Street, PO Box 2399, Doha; phone (974) 488-4101, extension 0 or 6500.
For after-hours emergencies, U.S. citizens may call (974) 488-4101, extension 0 or 6600, to reach the duty officer.
On the Internet, you may reach the Embassy web site at http://qatar.usembassy.gov for additional information and operating hours.
The embassy observes a Sunday through Thursday workweek.
Government offices and most businesses in Qatar also observe a Sunday through Thursday workweek.
*

*

*
This replaces the Country Specific Information for Qatar dated November 26, 2007, to update the sections on Entry/Exit Requirements, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Special Circumstances, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Tue 18 Feb 2020
Source: Qatari Ministry of Public Health [edited]

The Ministry of Public Health (MOPH) declared that a case of Middle East respiratory syndrome (MERS) has been confirmed. The case is a male citizen aged 65 years who has been suffering from several chronic diseases. The patient has been admitted to the hospital to receive the necessary medical care in accordance with the national protocol to deal with confirmed or suspected cases of the disease.

The Ministry of Public Health, in cooperation with the Ministry of Municipality and Environment, is taking all necessary preventive and precautionary measures to control the disease and prevent it from spreading.

MERS is a viral respiratory disease that is caused by one of the coronaviruses (MERS-CoV), but it differs from the novel coronavirus, known as COVID-19, which has recently spread in several countries. Both viruses differ in terms of the source of infection, mode of transmission, and the disease severity. The Ministry of Public Health confirms that no cases of the novel coronavirus (COVID-19) have been diagnosed in Qatar so far.

Only 3 cases of MERS-CoV were registered in Qatar during the past 2 years. The Ministry of Public Health calls on all members of public, and especially people with chronic diseases or those with immunodeficiency disorders, to adhere to public hygiene measures. This includes washing the hands regularly with water and soap, using hand sanitizers, as well as avoiding close contact with camels and seeking medical advice when experiencing symptoms of fever, cough, sore throat, or shortness of breath.

The Rapid Response Team of the Health Protection and Communicable Disease Control is available round-the-clock to receive notifications or inquiries related to communicable diseases on its hotline numbers 66740948 or 66740951.
======================
[In early December 2019, Qatar reported 3 cases of MERS-CoV infection, a fatal case and 2 asymptomatic contacts of the fatal case. The fatal case denied a history of contact with camels or recent travel. She did have a history of underlying medical conditions (which may have led to contact with the health sector in the 2 weeks prior to onset of illness). Prior to these cases, the most recent report of a case of MERS-CoV infection in Qatar was in 2017 when there were 3 cases reported (see prior ProMED-mail posts listed below.)

The location of residence of this patient was not available, nor were other epidemiological variables, including possible high risk exposures.

The HealthMap/ProMED-mail map of Qatar is available at
Date: Thu 26 Dec 2019
Source: WHO Emergencies preparedness, response, Disease outbreak news [edited]

Middle East respiratory syndrome coronavirus (MERS-CoV) - Qatar 26 Dec 2019
-----------------------------
On [5 Dec 2019], the National IHR Focal Point for Qatar reported 3 laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection to WHO.

The 1st case-patient (case #1) is a 67-year-old female from Doha, Qatar. She developed fever, cough, shortness of breath, and headache on [23 Nov 2019] and presented to a hospital on [25 Nov 2019]. On [27 Nov 2019], she went to the same hospital for follow-up. However, on [28 Nov 2019], her condition worsened, and she was admitted to the hospital. A nasopharyngeal swab was collected on [28 Nov 2019] and tested positive for MERS-CoV by reverse-transcriptase polymerase chain reaction (RT-PCR) on [29 Nov 2019]. The patient had underlying medical conditions and passed away on [12 Dec 2019]. The source of her infection is under investigation. The patient had neither a history of contact with dromedary camels nor recent travel. Follow-up and screening of 7 household contacts and 40 healthcare worker contacts is ongoing, and 2 asymptomatic secondary cases have been identified so far.

The 2 contacts are a 50-year-old (case # 2) and a 32-year-old (case # 3), living in Doha. Both were identified through contact tracing and are asymptomatic. Case #2 is the son of case #1 and has an underlying medical condition. Case #3 was involved in direct contact with case #1 and has no underlying medical conditions. A nasopharyngeal swab was collected on [29 Nov 2019] for both case #2 and case #3 and tested positive for MERS-CoV by RT-PCR on [29 Nov 2019]. As of [23 Dec 2019], both are in a stable condition in an isolation ward where protocols for infection prevention and control have been implemented.

Public health response
Upon identification of case #1, the case was isolated, the infection prevention and control protocols were implemented as per WHO guidelines, and investigation and contact tracing were initiated.

All 47 identified contacts of the patient have been monitored daily for the appearance of respiratory or gastrointestinal symptoms for a period of 14 days following their last exposure to the patient.

All contacts were tested for MERS-CoV, and test results were positive for 2 asymptomatic contacts (cases #2 and #3 mentioned above).

WHO risk assessment
Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels. MERS-CoV has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in healthcare settings.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to dromedary camels, animal products (for example, consumption of camel's raw milk), or humans (for example, in a healthcare setting or household contacts).

WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.

WHO advice
Based on the current situation and available information, WHO encourages all member states to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in healthcare facilities. It is not always possible to identify patients with MERS-CoV infection early because like other respiratory infections, the early symptoms of MERS-CoV infection are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol-generating procedures.

Early identification, case management, and isolation, together with appropriate infection prevention and control measures, can prevent human-to-human transmission of MERS-CoV.

MERS-CoV appears to cause more severe disease in people with underlying chronic medical conditions such as diabetes mellitus, renal failure, chronic lung disease, and compromised immune systems. Therefore, people with these underlying medical conditions should avoid close unprotected contact with animals, particularly dromedary camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
==================
[If this patient had not deteriorated on 28 Nov 2019, she most likely would not have been tested for MERS-CoV infection, and the infection may well have been missed. It would be very interesting to see data from countries on the Arabian Peninsula outside of Saudi Arabia on what proportion of respiratory illnesses are being tested for MERS-CoV infection, and what are the criteria being applied to test for suspected MERS-CoV infection. This case outwardly did not have a history of contact with dromedary camels, nor did she have contact with known MERS-CoV-infected individuals. But how many of her known contacts had a history of a respiratory infection, and was any serology performed? Just musing out loud, falling back on the question, "Why is Saudi Arabia seeing so many cases, but not neighboring countries?"

According to the ECDC (European Center for Disease Control) rapid assessment of 29 Aug 2018, Qatar has previously reported 19 cases of MERS-CoV infection including 5 deaths, for a reported case fatality ratio of approximately 25% (<https://www.ecdc.europa.eu/sites/default/files/documents/RRA-Severe-respiratory-disease-associated-MERS-CoV-22nd%20update-29-aug-2018.pdf>). The most recent case confirmed by Qatar prior to this announcement was reported on 23 May 2017 (see MERS-CoV (34): Saudi Arabia, UAE, Qatar, WHO: http://promedmail.org/post/20170606.5087888). The inclusion of these 3 newly confirmed infections will bring this total to 22 cases of MERS-CoV infection including 5 deaths.

Qatar borders with the Eastern Region of Saudi Arabia not far from Hufoof, where there have been cases reported since 2017. See map at <https://www.nationsonline.org/oneworld/map/Arabia-Map.htm>. - ProMED Mod.MPP]
Date: Wed 24 May 2017
Source: State of Qatar, Ministry of Public Health - News [edited]

Ministry of Public Health (MOPH) has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed for a 29-years-old, resident in Qatar, marking the 3rd MERS-CoV case to be confirmed in the country this year [2017] and bringing the cumulative number of confirmed MERS-CoV cases since 2012 to 21 cases among whom 7 have died.

The patient is a camel worker and had complaints of fever and dry cough for several days. He sought medical attention in Hamad General Hospital where an X-Ray investigation suggested a severe pneumonia. Consequently and as he reported an occupational frequent contact with camels, further samples were withdrawn from the patient. He ultimately tested positive for MERS-CoV according to Hamad Medical Corporation laboratories.

Despite his stable condition, the patient was admitted to hospital; in consistence with the national infection prevention and control protocol for confirmed and suspected MERS-CoV cases to ensure the appropriate medical attention. However, neither a history of contact with similar cases nor a recent travel outside the country was reported for the patient who has no comorbidities.

Once the case has been confirmed, the rapid response team of the Health Protection and Communicable disease Control (HP & CDC) department at the MOPH, accompanied with the team from Animal Health Department, Ministry of Municipality and Environment, have started a field investigation to assess the possible source of the infection and to verify whether any of the patient contacts has suspected symptoms according to the WHO standard case definition. Consequently, all traced contacts will be monitored over a period of 2 weeks, while those who develop suspected symptoms will then be subjected to confirmatory laboratory investigation.

The Ministry of Public Health advices citizens and residents, in particular those with comorbidities or low immunity, to abide to cough etiquette and handwashing with soap and water thoroughly and avoid unnecessary contact with sick animals.

MOPH proclaimed that Health Protection & CDC Hotlines 66740948 & 66740951 are accessible 24/7 to respond to any notification or enquiry related to infectious diseases.
==================
[The above press release mentioned the participation of animal health experts in the investigation of the described case. Information on their observations and findings, including results of laboratory tests (in case animal samples were taken), will be appreciated.

Qatar officially notified the OIE about its 1st event of MERS-CoV in camels, as an emerging disease, on 28 Nov 2013. The start of the event was, reportedly, dated 14 Oct 2013. The 'affected population' was kept on a "small farm with 14 camels, one sheep, one pigeon cage and some chicken" in Al-Shahanya, Ar Rayyan district. The diagnostic laboratory, given as "the Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), the Netherlands (OIE Reference Laboratory)", established the diagnosis of MERS-CoV in camels by PCR, on 26 Nov 2013. The report included the following epidemiological comment: "The health authority in Qatar notified the presence of a confirmed human MERS-CoV case. A joint team from both health and veterinary authorities was sent to the patient farm to investigate the health status of animals and the contact person. A farm worker proved to be positive for MERS-CoV and samples were collected from the 14 existing camels in addition to one sheep, some pigeons and chickens and some environmental samples (water, soil, animal food and grass) and all were sent to the Netherlands for testing. All animals were kept under observation and quarantine and all were apparently healthy". The above immediate notification was followed by 3 follow-up reports (29 Dec 2013, 22 Apr 2014 and 09 Jun 2014).

Follow-up report No 1, submitted a month later, namely on 29 Dec 2013, informed: "There are no new outbreaks in this report". The report, however, included the following epidemiological comments: "The samples from the same herd tested, using the same technique were negative and this may show that MERS-CoV infection in camels is a self-limiting disease. The planned massive survey for MERS-CoV in animals is under implementation and the same herd is under systematic retesting. Follow-up reports will be submitted when there will be new data".

Follow-up report No 2, submitted 22 Apr 2014, addressed "A single barn of 26 camels of different ages" in the same location (Al-Shahanyain), Qatar. The diagnostic laboratory was named as "Department of Viroscience, Erasmus Medical Center, Rotterdam (The Netherlands) (Foreign laboratory)"; the tests were performed on 19 Apr 2014, applying PCR and virus isolation, both positive. The report included the following epidemiological comments: "During an existing survey (pilot phase of the survey), nasal swabs were collected from an 8-month-old camel among healthy dromedary camels. The sample was inoculated on Vero cells and cytopathic changes were observed in cells at 48h post-infection. Human hepatoma cells (Huh-7 cells) were inoculated with MERS-CoV to further functionally characterize this viral isolate. After 2 days, virus-induced cytopathic effects were observed in the inoculated cell cultures. Virus production in Huh-7 cells was blocked by pre-incubating MERS-CoV with a 1/200 dilution of serum from MERS-CoV antibody positive camels. Conclusion: these data demonstrate that the MERS-CoV obtained from a dromedary camel is able to replicate in human cells and uses DPP4 as entry receptor, similar as isolates obtained from MERS patients".

Follow-up report No 3, submitted 9 Jun 2014, involved 3 barns with a total number of 12 camels of different ages, similarly in Al-Shahanya. Of the 12 susceptible camels, there were 5 "cases", indicated as an apparent morbidity rate of 41.67 percent. The diagnostic laboratory was "Erasmus Medical Center (Rotterdam) and National Institute for Public Health and the Environment (Bilthoven), The Netherlands (Foreign laboratory)", which applied SNT. This report included the following epidemiological comment: "Milk was collected according to local customs; cria's (dromedary calves) were not weaned after delivery but kept at the farm in paddocks adjacent to their dams throughout lactation. Dams were reunited with their cria to trigger milk production. Once milk production was initiated, the milk samples were collected by the camel owner or caretaker without specific hygienic precautions". The named follow-up report No 3 was the last report of MERS-CoV in camels submitted so far by Qatar to the OIE. It included the statement "continuing". No additional MERS-CoV reports from Qatar have become available since June 2014.

According to WAHID's archive data, the summary of the event since its start, as of June 2014, was:
Total outbreaks = 3 (Submitted)
Species/ Susceptible/ Cases/ Deaths/ Destroyed/ Slaughtered
Camelidae/ 52/ 9/ 0/ 0/ 0
(see at <http://www.oie.int/wahis_2/temp/reports/en_fup_0000015380_20140610_175414.pdf>).

In May 2017, the OIE updated its case definition for the reporting of MERS-CoV, as follows:

"1. Introduction
Dromedary camels have been confirmed by several studies to be the reservoir of the MERS-CoV infection in humans. Zoonotic transmissions of MERS-CoV from dromedary camels to humans were reported in multiple occasions. MERS-CoV has never been reported as a disease in camels though in experimental infections MERS-CoV has been associated with mild upper respiratory signs. Positive PCR results for MERS-CoV or isolation of the virus from camels is notifiable to the OIE because MERS is an emerging disease with a significant public health impact.

2. Confirmed case:
A dromedary camel with laboratory confirmation (*note 1) of MERS-CoV infection, with or without clinical signs.

3. Suspected case:
a) Observed clinical signs of mild respiratory infection (rhinitis in young dromedaries); and
b) Direct epidemiologic link (*note 2) with a confirmed human or camel MERS-CoV case; and
c) Testing for MERS-CoV is unavailable, negative or inconclusive (*note 4) on a single inadequate specimen (*note 3).

Notes
1 A case may be laboratory confirmed by virus isolation or detection of viral nucleic acid. The presence of viral nucleic acid can be confirmed by 1) a positive RT-PCR result on at least 2 specific genomic targets,
2) a single positive target with sequencing of a 2nd target or
3) a single positive target with positive result in a rapid MERS-CoV Ag Test. Serological investigations are of little value as high percentage of tested dromedaries possess antibodies to MERS-CoV.

2. A direct epidemiological link with a confirmed MERS-CoV dromedary camel may include living or traveling together in close proximity or sharing the same environment with individual dromedaries infected with MERS-CoV.

3. An inadequate specimen would include a specimen that has had improper handling, is judged to be of poor quality by the testing laboratory, or was taken too late in the course of illness.

4. Inconclusive tests may include a positive screening test on a single rRT-PCR target without further confirmation. Animals with an inconclusive initial test should undergo additional sampling and testing to determine if the animal can be classified as a confirmed MERS-CoV case. At herd level, having positive single target PCRs in more than one animal could constitute confirmation. Preference should be a repeat nasopharyngeal specimen. Other types of clinical specimens could also be considered for molecular testing if necessary, including blood/serum, and stool/rectal swab. These generally have lower titers of virus than respiratory tract specimens but have been used to confirm cases when other specimens were inadequate or unobtainable".

As commented by Mod.MPP (see http://promedmail.org/post/20170524.5059234), according to a review of cases reported by Saudi Arabia and classified as "primary" cases (N=560), 27.3 percent had a history of camel exposure, and 72.7 percent were reported as still under investigation for high risk exposures at the time of initial confirmation report. The 85th General Session of the World Assembly of OIE Delegates has been held in Paris during this week (21 to 26 May 2017). According to WHO updated information, MERS-CoV has caused, since its initial detection in Sep 2012, at least 1952 human cases, of which at least 693 deaths in 27 countries. It will be interesting to note if the reporting of this disease, according to the OIE criteria, and its possible control in the animal reservoir have been discussed during the General Session.

Subscribers are referred to a recent review paper (Ref 1), and in particular to figure 3 "Hypothesis of MERS-CoV transmission to humans".

A One Health approach to the MERS-CoV issue, its epidemiology and control, will require the active involvement of the 3 relevant international authorities, namely the FAO, OIE and WHO.

References
M. G. Hemida, A. Elmoslemany, F. Al-Hizab, A. Alnaeem, F. Almathen, B. Faye, D. K. W. Chu, R. A. P. M. Perera & M. Peiris. Dromedary Camels and the Transmission of Middle East. Transboundary & Emerging Diseases 64 (2017) 344-353.  <http://agritrop.cirad.fr/580073/7/Hemida_et_al-2017-Transboundary_and_Emerging_Diseases.pdf>. - ProMED Mod.AS]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Sat, 26 Nov 2016 20:00:07 +0100

Doha, Nov 26, 2016 (AFP) - Rainfall caused widespread flooding in Qatar on Saturday, potentially raising fresh concerns about infrastructure in the Gulf country due to host the 2022 football World Cup.   Several major roads were flooded, prompting official warnings.   "As the rain continues to pour in most parts of the country, motorists are advised to be cautious," the interior ministry tweeted after earlier calling the rainfall "medium to heavy".   Some apartment buildings on the Pearl Qatar, an artificial island in Doha, estimated to have cost $15 billion (13.5 billion euros) to build, suffered flooding, as did the nearby suburb of Qanat Quartier, built to resemble Venice.

The Doha News website reported that the Qatar Animal Welfare Society pleaded urgently for foster homes to take care of its dogs because of the conditions.   The Peninsula English-language newspaper reported that rain caused leaks at major Doha shopping centre the Landmark Mall.   Many people used social media to post videos and pictures, with some questioning how a relatively small amount of rain -- the first of the winter -- could cause such problems.   The wet weather had been predicted and the government "Rain Emergency Team" had already convened to discuss potential problems.

Last November, the government began an inquiry after rain damaged Doha's Hamad international airport, which opened in 2014, flooded roads and streets and caused some schools to close.   Gas-rich Qatar is spending more than $200 billion on major infrastructure such as roads, the airport, a metro system and a new city ahead of the 2022 World Cup, which will be played at this time of year -- from November 21 to December 18.   World Bank figures show Qatar's average annual rainfall is around 75 millimetres.
Date: Mon 13 Jun 2016 01:58 AM (Qatar)
Source: Gulf Times [edited]

The Ministry of Public Health has announced that a new Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been confirmed in a 23-year-old male resident, marking it the 3rd to be confirmed in the country this year [2016].

The person was not in contact with a confirmed case and does not suffer from any chronic diseases that usually cause immunity suppression. The patient was admitted to Hamad General Hospital as he reported fever, cough, runny nose, and backache where he tested positive for Mers-CoV. The patient is now stable and receives medical care in the isolation ward.

The ministry said that Health Protection and Communicable Disease Control Hotlines, 66740948 and 66740951, are accessible round-the-clock to respond to any notification or query related to infectious diseases.

MERS-CoV was 1st identified in Saudi Arabia in 2012.

According to the World Health Organization (WHO), globally, since September 2012, it has been notified of 1652 laboratory-confirmed cases of infection with MERS-CoV, including at least 591 related deaths [the most recent report from WHO on 16 May 2016 gives a global tally of 1733 laboratory-confirmed cases of infection with MERS-CoV, including at least 628 related deaths (<http://www.who.int/csr/don/16-may-2016-mers-saudi-arabia/en/>) - ProMED Mod.MPP].

Mers-CoV is a zoonotic virus that is transmitted from animals to humans.
==================
[As mentioned in the above report, this is now the 3rd case of MERS-CoV infection reported in Qatar in 2016. The 1st case was reported in February 2016 in a 66 year old Qatari male who had been, for 2 months preceding onset of illness, in Saudi Arabia where he had a camel farm (see MERS-CoV (35): Saudi Arabia, Qatar ex Saudi Arabia, WHO http://promedmail.org/post/20160311.4085518 and MERS-CoV (24): Qatar ex Saudi Arabia, Saudi Arabia (RI) RFI http://promedmail.org/post/20160222.4041719). The 2nd case was a 40 year old Qatari national camel worker with non-specific, non-respiratory symptoms (see MERS-CoV (56): Qatar, Saudi Arabia, WHO http://promedmail.org/post/20160503.4198200).

According to the most recent ECDC Communicable Disease Threats Report, as of 9 June 2016, there have been a total of 1753 cases of MERS-CoV infection, including 680 deaths reported by health authorities worldwide. Besides, there have been a total of 15 cases of MERS-CoV infection including 5 deaths reported by Qatar as of 9 Jun 2016, making this current case the 16th case reported by Qatar since April 2012.  (<http://ecdc.europa.eu/en/publications/Publications/Communicable-disease-threats-report-11-june-2016.pdf>).

In addition to the 16 cases reported by Qatar, there have been 2 additional cases reported in Qatari nationals treated in Europe (see Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar
East. Med. (07): Saudi Arabia, UK, Germany

We await further information on possible high risk transmission exposures.

The HealthMap/ProMED map of Qatar can be found at:
More ...

American Samoa

Samoa US Consular Information Sheet
January 23, 2008
COUNTRY DESCRIPTION:
Samoa consists of the two large islands of Upolu and Savai’i and seven small islets. The country has a stable parliamentary democracy with a developing economy. To
rist facilities are accessible by bus, taxi and car and are within walking distance of access roads. Infrastructure is adequate in Apia, the capital, but it is limited in other areas. Nearly all Internet connections use a relatively slow dial-up method. Samoa has two digital telephone service providers, and visitors can easily purchase prepaid phones that cover virtually the entire country. The Samoa Tourism Authority, at http://www.visitsamoa.ws/, provides a wide range of information of interest to travelers. Read the Department of State Background Notes on Samoa for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. nationals who are not U.S. citizens, and who are resident in American Samoa, must obtain a visitor permit prior to all travel to Samoa. U.S. nationals have not been permitted to travel to Samoa on certificates of identity since May 2005 except on a case by case basis. (U.S. law distinguishes between individuals who are citizens and those who are nationals. The U.S. passport bio-page shows one’s status as either a citizen or a non-citizen national.) As of March 22, 2006, visitor permits to travel to Samoa can be applied for at the new Samoa Consulate General office in Pago Pago, American Samoa. A valid passport and an onward/return ticket are required for all Americans (both citizens and nationals) to travel to Samoa. Visitor permits are not required for U.S. citizens (only for U.S. nationals) seeking to stay in Samoa for up to 60 days. All visitors are required to pay a departure tax of 40 Tala (approximately 17.50 USD) upon leaving the country. Further information about entry requirements and the departure tax may be obtained from the Samoa Mission to the United Nations at 800-2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196, fax (212) 599-0797. Visit the Embassy ofSamoa web site at http://www2.un.int/public/Samoa/ for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
In Apia and many villages, stray dogs wander the streets. Visitors should not approach or feed them; they can become aggressive in the presence of food or if they feel threatened.

Although there have been no major accidents involving the ferry service linking Upolu and Savai’i, vessels are sometimes overloaded. One of the ferries, a multi-deck automobile ferry, sometimes transports passengers on its automobile deck. Americans who choose to use this ferry are encouraged not to remain in the automobile deck during the crossing and to ride only in the passenger compartment in order to avoid injury from shifting vehicles.

Samoa has numerous “blowholes” (lava tubes open to the sea where wave action produces, often spectacular, geysers). These blowholes are popular tourist attractions. The footing around the mouths of most blowholes is very slippery. To avoid being swept in, visitors should not approach too closely and should never stand between the opening of the blowhole and the sea.

Snorkeling and diving in ocean lagoons is a popular activity for many visitors to Samoa. Tide changes can produce powerful currents in these lagoons. Visitors are encouraged to consult local residents and tour operators about hazards and conditions at a particular location before venturing into the water.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Overall, Samoa is considered a low threat environment. Nevertheless, visitors should remain aware of their surroundings, lock their doors at night, and not leave their belongings unattended. Incidents of petty theft/robberies of personal effects are common. Some such incidents have involved residential break-ins. While rare, violent assaults, including sexual assaults have occurred in Samoa. No specific groups have been targeted, nor have there been any racially motivated or hate crimes against Americans. Police responsiveness in Apia is generally good. Because of the very limited police presence elsewhere in Samoa (where order is maintained primarily by local village authorities), police responsiveness elsewhere is problematic.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Health care facilities in Samoa are adequate for routine medical treatment, but are limited in range and availability; complex illnesses and life-threatening emergencies generally need to be treated elsewhere. Dental facilities do not meet U.S. standards, but good dental treatment and some emergency care can be obtained nearby at the LBJ Tropical Medical Center in Pago Pago, American Samoa. The national hospital and a small private hospital are located in Apia, and there are several small district hospitals on Savai'i and in outlying areas of Upolu. There are no hyperbaric chambers on any of the islands for the treatment of scuba diving related injuries. Serious cases of decompression sickness are evacuated to the nearest treatment center in Suva, Fiji, or Auckland, New Zealand. Serious medical conditions and treatments that require hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Travelers should carry emergency evacuation insurance. Doctors and hospitals often expect immediate cash payment for health services. There is no reported incidence of malaria or rabies in Samoa. Occasional outbreaks of typhoid and non-hemorrhagic dengue do occur.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Samoa is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Safety of public transportation and rural road conditions in Samoa, are considered fair, while urban road conditions/maintenance is considered good. Taxis in particular are widely available and used by Samoans and visitors alike; buses are slow, generally crowded and uncomfortable, and rarely utilized by visitors. Rental cars can also be obtained. No roadside assistance is available. Most major roads are tar-sealed, but secondary roads are predominantly dirt and gravel and may be overgrown with vegetation. A four-wheel drive vehicle is recommended for travel on these roads. Travelers should be aware that vehicle safety regulations are rarely enforced and traffic violations occur routinely. Roads outside Apia are often narrow, winding, relatively steep, with narrow or no shoulders, and poorly lighted. Pedestrians as well as vehicles and livestock regularly travel these roads. Due to poor and deteriorating road conditions, night driving on unlit rural roads can be dangerous and should be avoided if possible. Roads in Samoa often traverse small streams. Drivers are urged to exercise extreme caution when fording these streams, which can become swollen and dangerous with little warning. Vehicles should never enter a stream if the roadbed is not visible or if the water’s depth exceeds the vehicle’s clearance.

Speed limits in Samoa are 25 miles per hour in the Apia area and 35 miles per hour outside Apia, with certain exceptions. At unmarked intersections, traffic on the left has the right of way. As in the United States, vehicular traffic moves on the right side of the road; although right-hand-drive vehicles (mainly from New Zealand) do exist in Samoa. Importing right hand drive vehicles to Samoa is currently legally forbidden.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at Samoa Tourism Authority at http://www.visitsamoa.ws/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government ofSamoa’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Samoa’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Some overseas treatment centers, known as Behavior Modification Facilities, operate in Samoa. Though these facilities may be operated and staffed by U.S. citizens, the Samoan government is solely responsible for compliance with local safety, health, sanitation and educational laws and regulations, including all licensing requirements of the staff in country. These standards, if any, may not be strictly enforced or meet the standards of similar facilities in the U.S. Parents should be aware that U.S. citizens and non-citizen nationals 14 years of age and older have a right to apply for a passport and to request repatriation assistance from the U.S. government, both without parental consent. Any U.S. citizen or non-citizen enrollee has the right to contact a representative from the U.S. Embassy. For further information, consult the Department of State's Fact Sheet on Behavior Modification Facilities, available via the Bureau of Consular Affairs home page. Parents may also contact the U.S. Embassy in Apia or the country officer in the Office of American Citizens Services, Bureau of Consular Affairs at 202-647-5226.

Financial Transactions:
Although some businesses (especially those in Apia or those frequented by tourists) do accept credit cards, many (including gas stations) do not. Major credit cards (Visa, Master Card, and American Express) are accepted at major hotels and some restaurants and stores. Samoan currency can be obtained from ATMs, which are located in Faleolo Airport and in many locations in Apia. For more information on ATM locations and banking services see ANZ web site at http://www.anz.com/samoa/overview.asp and WESTPAC web site at http://www.westpac.com.ws/pacific/publish.nsf/Content/PFSA+HomePage.

Disaster Preparedness: Samoa is located in an area of high seismic activity. Although the probability that a major earthquake would occur during an individual trip is remote, earthquakes can and will continue to happen. Major cyclones have occurred in the past and are always a concern. Strong winds and very heavy rains are common, especially during the rainy season from November to April. During this period, Samoa receives most of its annual average of over 130 inches of rain. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency’s (FEMA) web site at http://www.fema.gov/.

Customs: Samoa customs authorities may enforce strict regulations concerning temporary importation into or export from Samoa of items such as firearms, fruits, pets and other animals, and drugs. It is advisable to contact the Samoan Mission to the United Nations at 800 2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196 for specific information regarding customs requirements. Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Samoa’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Samoa are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
Samoa is not a member of the Hague Convention on the Civil Aspects of International Child Abduction. For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/EMBASSY LOCATION:
Americans living or traveling in Samoa are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security withinSamoa. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in the Accident Compensation Board (ACB) Building, Fifth Floor, Apia. The Embassy is open to the public from 8:15 a.m. to 5:00 p.m. Monday - Friday. The Embassy's mailing address is U.S. Embassy, P.O. Box 3430, Apia, Samoa 0815. The telephone numbers are (685) 21436/21631/22696 and 21452. The fax number is (685) 22030. An Embassy officer can be reached after hours in an emergency involving the welfare of a U.S. citizen or non-citizen national at (685) 21514 or (685) 777-1776. Visit the U.S. Embassy’s web site at http://samoa.usembassy.gov/.
* * *
This replaces the Consular Information Sheet (now known as Country Specific Information) dated May 21, 2007, to update sections on Country Description and Crime.

Travel News Headlines WORLD NEWS

American Samoa. 8 Mar 2017.
(susp) as of mid-February 30 cases of Dengue.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific can be accessed at <http://healthmap.org/promed/p/380>
and a map of the island at <http://www.nationsonline.org/maps/tutuila-island-map.jpg>. - ProMED Mod.TY
Date: Sat 20 Sep 2014
Source: Radio New Zealand [edited]

Latest figures from Samoa's Ministry of Health show an increase of suspected and confirmed cases of chikungunya [virus infections] from 400 to 626 since the outbreak of the acute fever, rash and joint pain disease was reported in July [2014].

However, the ministry says so far presentation of the main signs and symptoms of those affected have largely been mild.

The highest number of people affected is recorded in the districts of Vaimauga west in the urban area with 151 cases; Faleata east, 139 cases; and 113 in Faleata west.  The majority of patients is young.

In American Samoa, the chikungunya outbreak is on the wane. Health officials say there are now 823 probable cases of the mosquito-borne illness, with 15 people requiring hospital care.
===========
[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014 to 433 reported on 8 Sep 2014 and now to 626 cases. One hopes that a prompt and aggressive clean up of breeding sites will reduce the vector mosquito population enough to halt, or at least reduce, transmission.

On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month, apparently peaking at 823 probable cases reported above. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A map showing the location of Samoa in the Pacific Ocean can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/wsnewz.gif>. A HealthMap/ProMED-mail map showing the location of both Samoa and American Samoa in the Pacific Ocean can be accessed at <http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
Date: Mon 9 Sep 2014
Source: Radio New Zealand [edited]
<http://www.radionz.co.nz/international/pacific-news/253977/chikungunya-related-cases-reach-over-700-in-american-samoa

The latest reports from American Samoa reveal that chikungunya-related [febrile] cases have now reached over 700, and there is now one probable case in Ofu, Manua. The virus was discovered in the territory in July 2014, but there have been no reported cases in Manua until now.

Health officials are urging residents not to travel to Manua if they have chikungunya, and testing is being done to determine whether the case in Ofu is due to the virus. Since July 2014, there have been 11 hospitalisations with the virus but no deaths.

Health officials continue to urge those with symptoms to drink plenty of fluids, get a lot of rest, and visit the emergency department if symptoms become serious.
=======================
[On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific Ocean can be accessed at
Date: Tue 5 Aug 2014
Source: Radio New Zealand International [edited]

The American Samoan Department of Health says there are now more than 300 confirmed cases of chikungunya or 'chik' virus in the territory.

The Health Director Motusa Tuileama Nua says his department and LBJ hospital have confirmed the outbreak of fever, rashes, and joint pains among people on the main island of Tutuila is due to chikungunya.

He says there have been 343 recorded cases, with 6 patients hospitalised and no deaths, since the beginning of July [2014].

He recommends those who are ill with fever and body aches do not travel off island.
--------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===============
[CHIKV has been circulating in Pacific islands this year (2014).

Maps showing the location of American Samoa in the Pacific Ocean can be accessed at
<http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
****************************
American Samoa: confirmed
Date: Fri 8 Aug 2014
Source: Samoa News [edited]

The American Samoa Department of Health and the LBJ hospital have created a 24 hour a day hotline for the CHIK virus. The CHIK hotline number is 731-7511.

The Health Alert issued yesterday [7 Aug 2014] confirms chikungunya (CHIK) virus as the cause of fever, rash, and joint pains outbreak on Tutuila and there have been more than 390 recorded cases, with 7 patients hospitalized and no deaths since 1 Jul 2014.

According to the health alert, there is no cure for CHIK virus [infection, and] it can usually be treated at home by drinking lots of fluids, taking pain medicine like Tylenol, ibuprofen, or Aleve as needed but only as much and with cautions as recommended on the package.

The health alert urges not to work while your joints are painful, let them rest and apply ice or cold packs on the joints and this may protect against prolonged joint pain.

DOH notes you should go to the Emergency Room to see a doctor if symptoms persist more than 10 days, or if you have bleeding from any part of the body or bruised skin. Call the hotline "or come to the ER or clinic if you are worried about your condition getting worse."

The alert once again urges that people stay indoors in air-con, behind screens, or under bed nets while you are ill, because if you are bitten by mosquitoes while you are ill, you can spread the disease to your family and neighbors.

For travelers, the DOH urges those who are ill not to travel off island, including to Manu'a. "If you travel and become ill when you arrive, tell the doctor who sees you that you may have been exposed to the CHIK virus."  [Byline: B. Chen]
----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
-----------------------------------
[Interestingly, the 5 Aug 2014 report above indicated that there were 343 reported cases, and in the subsequent report of 8 Aug 2014 above, that number has increased to 390 cases, indicating that transmission of CHIK virus is continuing. - ProMed Mod.TY]
******
Samoa: suspected cases
Date: Fri 8 Aug 2014
Source: Island Business [edited]

Samoa's Ministry of Health has reported 2 deaths from acute fever and rash, saying it is now an outbreak. A press statement from the Director General, Leausa Toleafoa Dr Take Naseri, says there have been 21 recorded cases as of earlier this week with 4 people hospitalised.

The cases are suspected to be chikungunya virus, similar to dengue fever, but results are yet to be confirmed and 3 children and one man have been admitted to the intensive care unit.

The ministry says collaboration with other government agencies, and media campaigns, aim to raise awareness of the outbreak and help its containment.

Samoa has also sought assistance from the Ministry of Health's development partners including the Secretariat of the Pacific Community and the World Health Organisation.

In neighbouring American Samoa, there have been more than 300 confirmed cases of chikungunya.
======================
[This is the 1st ever ProMED-mail report of a chikungunya outbreak in Samoa. Concerning the current outbreak, it would be unusual to have 2 deaths from chikungunya virus infections of a total of 21 recorded cases. One explanation for the high proportion of fatal cases could be significant underreporting of non-fatal cases. No mention is made indicating that there were contributory underlying medical conditions in these 2 fatal cases. ProMED-mail will be interested in receiving results of the laboratory tests when they become available.

Maps showing the location of Samoa in the Pacific Ocean can be accessed at
at <http://healthmap.org/promed/p/2>. - ProMed Mod.TY]
Date: Wed 14 May 2014
Source: Radio New Zealand International [edited]

Health officials in American Samoa are warning the public about an amoebic dysentery outbreak which has so far affected 26 people, half of which have been admitted to the LBJ hospital. A Pacific Island Health Officers' Association Epidemiologist, Mark Duran, says the department of health is leading an investigation into the source of the parasite.

Dr Duran says amoebic dysentery is spread through contamination of human waste. "It especially attacks the intestines and invades its way into the wall of the intestines; it causes abdominal pain, it causes bloody diarrhoea, fever." Dr Duran says in serious cases the parasite can travel through the body and cause abscesses especially in the liver.
===================
[Maps of American Samoa can be seen at
<http://healthmap.org/promed/p/380>. - ProMed Sr.Tech.Ed.MJ]
More ...

World Travel News Headlines

Date: Tue, 7 Apr 2020 13:16:35 +0200 (METDST)

Madrid, Spain, April 7, 2020 (AFP) - Spain's daily coronavirus death toll shot up to 743 on Tuesday after falling for four straight days, lifting the total to 13,798, the health ministry said.   However, it emphasised that the rise was due to weekend deaths being tallied and that the overall "downward trend" is continuing.   The new figure represents a 5.7 percent increase over the 637 deaths recorded on Monday, the lowest number of fatalities since March 24 in the world's second hardest-hit country after Italy in terms of deaths.

The number of new infections also grew at a faster pace, rising 4.1 percent to 140,510, the health ministry said. The number of new cases had risen by 3.3 percent on Monday.   The "slight" rise was due largely to the fact that many deaths and new infections which occur over the weekend are only now being tallied, said Maria Jose Sierra of the health ministry's emergencies coordination unit.   "In reality the downward trend is what we continue to observe in the reports we have received in recent days," she told a daily news conference to discuss the figures.   The number of people in hospital intensive care units continues to fall, she added.   Spain had seen the number of new infections and death drop each day since it recorded a record 950 fatalities on Thursday.   But the percentage increase in the number of new deaths is far lower than the 32.63 percent leap recorded as recently as March 21.

Mari Angels Rodriguez, a nurse at the Hospital Josep Trueta hospital in Girona in northeastern Spain, said the volume of work in the intensive care unit had fallen "a lot".   "The collapse in the first few days was brutal, everyone was coming to emergency services, all the usual causes as well as all the possible cases of COVID-19," she told AFP.   "What wears me out the most is seeing young and middle aged people, without chronic conditions, who arrive in moderate shape and quickly end up in the intensive care unit (ICU)."   "The other day a 17-year-old girl was admitted to hospital and the next day she was in the ICU. It is full of young people. Psychologically you are not ready for this," she added.   "It hits you the speed with which a patient gets seriously ill. When they start to get bad, it is like they are drowning, in half an hour they are intubated or are dead."
Date: Tue, 7 Apr 2020 12:57:35 +0200 (METDST)

Seoul, April 7, 2020 (AFP) - Two elderly South Korean coronavirus patients recovered from severe pneumonia after being treated with plasma from survivors, researchers said Tuesday, offering hope in the face of the global pandemic.   Scientists have pointed to the potential benefits of plasma -- a blood fluid -- from recovered individuals who have developed antibodies to the virus enabling the body's defences to attack it.   Since emerging in China in December, the coronavirus has killed almost 75,000 people as drugmakers worldwide race to develop a vaccine and treatments for the disease.

Plasma therapy could become "an alternative treatment for patients in critical condition who do not respond to antiviral drugs," said Choi Jun-yong, a doctor and researcher at Severance Hospital in Seoul, where both patients were treated.   But large-scale clinical trials were needed to prove its effectiveness, he added.   One of the two patients was a 71-year-old man with no underlying conditions who only improved when treated with plasma from a recovered patient in his 20s, along with steroids.   He was initially given malaria drugs and a respirator for severe pneumonia.   The other patient, a 67-year-old female, also did not respond to initial treatments including malaria, HIV drugs, and oxygen therapy. She began to recover after receiving plasma therapy and steroids at the same time, researchers said.

Their findings were published in the peer-reviewed Journal of Korean Medicine.   Kwon Jun-wook, an official at Seoul's Central Disease Control Headquarters, said plasma therapy was "important" when there was "currently no vaccine or treatment available" for the virus.    He called on experts to examine the two cases urgently.   Research on plasma and other therapies "will proceed quickly", Kwon added.   Small studies on plasma have demonstrated its effectiveness in treating infectious diseases, including Ebola and SARS.

Trials started in France on Tuesday involving 60 patients in Paris hospitals, half of whom will receive plasma from recovered patients.   The US Food and Drug Administration authorised physicians to experiment with the strategy to fight the coronavirus, and tests are also being carried out in China.   South Korea endured one of the worst early outbreaks of the virus, but appears to have brought it under control thanks to its extensive "trace, test and treat" programme.
Date: Tue, 7 Apr 2020 12:55:32 +0200 (METDST)

Athens, April 7, 2020 (AFP) - Hundreds of Greek healthcare workers demonstrated on Tuesday to protest at working conditions and lack of manpower and equipment in public hospitals during the coronavirus pandemic.   The demonstrations were staged to coincide with World Health Day, according to the federation of hospital personnel.   "You only saw us when we covered our faces," proclaimed a poster printed by hospital trade unions, bearing a picture of doctors wearing anti-coronavirus masks.    Demonstrators at the large Evangelismos hospital in central Athens held up signs demanding job hiring, virus testing and hospital equipment.

Police tried to enter the hospital courtyard where the rally was taking place before being forced back by demonstrators, an AFP photographer said.   A similar protest was held at the main hospital in Larissa in central Greece, according to images from public television ERT.    Despina Tossonidou, president of the doctors' union at Voula hospital in southern Athens, said that in addition to the hiring of medical staff, intensive care units in private clinics should be requisitioned "to overcome the shortcomings of the public sector" during the virus crisis.   Health care in Greece was drastically affected by the country's 2010-2018 financial crisis and tough austerity required by creditors in exchange for bailouts.

As part of its measures to deal with the pandemic, the government has offered clinics 30 million euros ($32.6 million) and announced the hiring on short-term contracts of 2,000 doctors and 2,000 nursing staff.    "These measures are just a drop in the ocean," said Tossonidou, a radiologist.    "The hospital system needs 30,000 additional permanent doctors," she said, also citing the lack of protective equipment and COVID-19 testing in hospitals.    "The majority of tests are currently carried out in private hospitals at costs ranging from 150 to 300 euros ($163-326)," said Tossonidou.    Greece, a country of around 10.7 million people, has suffered relatively less than other European nations in the pandemic, recording 81 deaths out of 1,755 cases.
Date: Tue, 7 Apr 2020 11:28:32 +0200 (METDST)

Tokyo, April 7, 2020 (AFP) - Japan on Tuesday declared a state of emergency over a spike in coronavirus cases, ramping up efforts to contain infections but stopping short of the strict lockdowns seen in other parts of the world.  The government has come under mounting pressure to tackle an outbreak that remains small by global standards but has raised concerns among Japanese medical experts, with warnings that local healthcare systems are already overstretched.   "As I decided that a situation feared to gravely affect people's lives and the economy has occurred... I am declaring a state of emergency," Abe said.   The move allows governors in seven affected regions including Tokyo to ask people to stay indoors and request businesses close.

But many supermarkets and other shops will stay open, transport will continue to run and there are neither enforcement mechanisms nor penalties laid out for those who fail to comply with government requests.   "Although a state of emergency is declared, it won't mean a city lockdown as seen overseas," Abe said.   "We will prevent the spread of infection while maintaining economic and social services such as public transport as much as possible."   Pressure to declare an emergency had increased after Tokyo reported several days of record infections, with 143 new cases logged on Sunday.

Tokyo Governor Yuriko Koike has already asked residents of the capital to avoid unnecessary outings and work from home, but had pushed for an emergency declaration to give her requests legal strength.   Seven regions are covered by the month-long declaration: Tokyo, neighbouring Chiba, Kanagawa and Saitama, the western hub of Osaka and neighbouring Hyogo, and the southwestern region of Fukuoka.   The measure will last through to the end of the Golden Week holiday period, when much of the country travels in a rare break.

- 'Lives at stake' -
"It may cause inconvenience in daily life, but I call for everyone's cooperation because lives are at stake," Koike told reporters earlier.   The measure also allows governors to commandeer property for medical purposes and close public facilities like schools, many of which have already shut down.   The economic impacts of the measure and the broader global pandemic have raised concern of a recession in Japan, and Abe on Monday unveiled plans for a stimulus package worth around $1 trillion, or 20 percent of gross domestic product.

Japan has so far been spared the sort of virus outbreak seen in parts of Europe and the United States, with close to 4,000 confirmed infections and 80 deaths.   But medical experts have repeatedly sounded the alarm in recent weeks, citing the rapid increase of infections in parts of the country.    And on Monday, doctors in Tokyo said the situation in the capital was already in "critical condition".

- Public backing -
In a bid to ease the pressure, rules requiring people infected with the virus to stay in hospital even if their symptoms are mild have been relaxed, with Koike saying hotels would be designated as quarantine facilities for those in non-serious condition.   The government has also pledged to step up testing capacity and the number of beds and ventilators available to treat those in serious condition.

The state of emergency is a relatively relaxed approach to lockdown compared to other parts of the world, a function of Japan's legal system, which restricts the government's ability to limit the movement of citizens.   "Japan is still haunted by the negative legacy of the war and the oppression of its citizens," said Yoshinobu Yamamoto, an emeritus professor of international politics at the University of Tokyo.   But he warned that there could be calls for stronger measures if the outbreak continues to spread.

Japan saw its first case of the virus in mid-January, and came under heavy criticism for its handling of the coronavirus-wracked Diamond Princess, where an on-board quarantine ended with over 700 people contracting the virus and 11 deaths.   In the capital, people expressed support for the state of emergency, with some saying they felt it should have been declared sooner.   "When you see on TV what's going on in New York with the cases doubling within three, four days, it really sends chills down my spine," 76-year-old Mitsuo Oshiyama told AFP.   "I don't understand why the government waited so long."
Date: Tue, 7 Apr 2020 10:17:01 +0200 (METDST)

Helsinki, April 7, 2020 (AFP) - Finland announced tougher controls on Tuesday to further reduce arrivals from its neighbours including Sweden, where measures to tackle the coronavirus have been less severe and infection rates  higher.   The two countries' land border in Lapland is usually crossed by thousands of workers and families every day, although traffic across the Swedish and Norwegian borders has fallen by 95 percent since the government banned all but essential traffic on March 14, Finland's Interior Minister Maria Ohisalo told a press conference.   "In addition to extending the measures (for a month until May 13), quarantine requirements for arrivals will be tightened," Ohisalo said.

Under the new measures, workers must now carry a permission slip from their employer stating that the border crossing is essential and must remain under quarantine for 14 days on arrival in Finland.    The measures come after a senior Finnish infection specialist called for an end to work-related travel over the Lapland border, where 2,000 border crossings a day were still being made.    "It is a significant risk when so many people are coming through the border every day," Dr Markku Broas of Lapland Central Hospital told Finnish public broadcaster Yle on 29 March.

As of Monday, Sweden had recorded 477 deaths from coronavirus, compared with just 27 in Finland.   But while Finland has imposed emergency laws closing schools, blockading its capital region and forcing restaurants to close, Sweden has taken a notably softer approach with far fewer restrictions than elsewhere in Europe.

On Tuesday, Finland also announced that passenger ferries linking Finland with Germany, Estonia and Sweden would also stop selling tickets from Friday, as all existing restrictions on movement were extended for a further month until May 13.   Ohisalo told the press conference that the measures so far had succeeded in slowing the spread of the virus in Finland and that the government would begin "an exit conversation" in the coming days about when to roll back the restrictions.
Date: Tue, 7 Apr 2020 07:07:55 +0200 (METDST)
By Philippe Carillo

Port Vila, Vanuatu, April 7, 2020 (AFP) - A deadly cyclone destroyed much of Vanuatu's second-largest town but early warnings appeared to have prevented mass casualties in the Pacific nation, with some residents sheltered in caves to stay safe, aid workers said Tuesday.   Tropical Cyclone Harold, which claimed 27 lives when it swept through the Solomon Islands last week, lashed Vanuatu's northern provinces overnight as a scale-topping category five superstorm.   The town of Luganville, population 16,500, took a direct hit as winds of 235 kilometres per hour (145 miles per hour) brought down buildings and caused flash flooding.

World Vision's Vanuatu director Kendra Gates Derousseau said the charity's local manager told her the damage was comparable to the last category five monster to hit the country, Cyclone Pam in 2015.   "I managed to speak to her on a satellite phone and she estimated about 50 percent of dwellings have been significantly damaged, the World Vision office has lost its roof," she told AFP.   "She mentioned that she has heard no reports of casualties or any significant injuries at this time," the Port Vila-based aid worker added.

Communications remain down across much of the country and Gates Derousseau said the scale of the disaster would remain unclear until remote island communities, such as southern Pentecost, had been contacted.   "They were directly in the eye (of the cyclone) and they have very few concrete buildings, they shelter in traditional thatch dwellings or caves," she said.   Red Cross Vanuatu secretary general Jacqueline de Gaillande said the communications issues meant that the most recent updates she received were social media posts from the charity's local staffers on Monday evening.   "They showed a lot of damage but we have no numbers of casualties yet," she told AFP.

- COVID-19 complications -
A massive international aid effort was launched after Cyclone Pam in 2015 flattened Port Vila, killed 11 people and wiped out almost two-thirds of the country's economic capacity.   Gates Derousseau said a similar operation was unlikely in Harold's wake because Vanuatu was determined to remain one of the world's few places with no confirmed COVID-19 cases.   She said allowing an influx of international aid workers risked inadvertently importing the virus, so Vanuatu's international borders would remain closed to new arrivals.

"It (the aid effort) has to be locally led, locally driven, working with humanitarian partners who are currently in-country.   "There are already large stockpiles of supplies in place, which is a lesson we learned from Pam, so we can get to work fairly quickly."   She said replacement supplies could be brought in from overseas once the stockpiles ran out, but they would be disinfected to ensure they were virus-free.   Vanuatu lacks the health infrastructure to deal with even a mild coronavirus outbreak, with local media reporting last month that the nation of 300,000 has only two respiratory ventilators.

Cyclone Harold has already caused widespread damage in the Solomon Islands, where an inter-island ferry ignored weather warnings and 27 people died after being washed off its decks.   Modelling early Tuesday showed it continuing to track southeast, passing south of Fiji as a category four Wednesday and weakening to category two as it brushes Tonga a day later.   However, the storm system has already proved unpredictable, with forecasters initially expecting it to only reach category three before petering out.   Fiji on Tuesday pre-emptively issued cyclone alerts for its southern islands, warning of high seas and damaging gale-force winds.
Date: Tue, 7 Apr 2020 04:07:12 +0200 (METDST)

Copenhagen, April 7, 2020 (AFP) - Denmark is to gradually lift restrictions put in place to fight the new coronavirus, starting with the reopening of day-care nurseries, kindergartens and primary schools from April 15.   Prime Minister Mette Frederiksen said that according to health authorities "it is appropriate and justified to start a slow opening. But on condition that everyone keeps their distance and washes their hands."

The reopening of schools will take place gradually, with kindergartens and primary schools opening from April 15 and middle and high schools waiting until May 10, she told a press conference on Monday.   Bars, restaurants, nightclubs, shopping centres, hairdressers and massage parlours will remain closed, and gatherings of more than 10 people are still prohibited.   "Daily life is not going to return as before for the moment. We will live with many restrictions for many more months," the prime minister warned.   Border closures remain in place and travel abroad is not recommended.

Large gatherings are prohibited until August.   Frederiksen called on Danes to keep observing health rules and social distancing.   "A little slip in our individual behaviour can have a big impact on our well-being as a society," she said.    Denmark closed its borders to foreigners on March 14, the same day it recorded its first coronavirus fatality, and days later closed bars and restaurants and most shops.

The Nordic nation has recorded 4,875 infections and 187 deaths related to COVID-19.    It is the second European country after Austria to unveil its plans for a gradual easing of restrictions.
Date: Tue, 7 Apr 2020 00:04:15 +0200 (METDST)

Rabat, April 6, 2020 (AFP) - Wearing face masks in public will be obligatory in Morocco from Tuesday in a bid to stem the spread of coronavirus, according to an official decree.   The decision was announced late Monday after a government meeting on how to control the epidemic.   Morocco imposed a public health state of emergency on March 19, confining everyone to their homes except those with a permit to be out and about for their work.

Police, security agents and soldiers in armoured cars have been deployed around the country, erecting road barriers and control points.   The official number of COVID-19 cases in Morocco has doubled in a week to 1,120, including 80 fatalities.   The real numbers are likely to be significantly higher as there is a lack of testing gear in the country.
Date: Mon, 6 Apr 2020 22:58:13 +0200 (METDST)

Sao Paulo, April 6, 2020 (AFP) - The epicentre of the coronavirus outbreak in Latin America, Brazil's Sao Paulo state, said Monday it expects 111,000 deaths in the next six months, and extended its stay-at-home measures another two weeks.   The forecast -- an official projection, the state government said -- would appear to put Brazil on track to become one of the worst-hit countries in the world.   The global death toll from the virus currently stands at 70,000, according to a tally compiled by AFP.

Sao Paulo, the teeming industrial hub where the new coronavirus first appeared in Latin America, has confirmed 4,620 cases and 275 deaths so far.   Governor Joao Doria, who closed non-essential businesses on March 24 and advised people to stay home, said containment measures would be needed for at least two more weeks or the situation would get far worse.   "If we continue seeing people in the streets and gathering unnecessarily, we will go to more restrictive measures," he told a news conference.   Police are already authorized to break up crowds by force if necessary, he said.

Without containment measures, Sao Paulo -- whose capital is the mega-city of the same name -- would register 270,000 deaths in the next six months, said the head of the state's public health research institute, Dimas Covas.   Brazil has been the Latin American country hit hardest by the new coronavirus, with 553 deaths and more than 12,000 confirmed cases so far.   Health experts warn under-testing means the real number is likely much higher.

Sao Paulo, a state whose population of 46 million makes it about the size as Spain, has seen more infections and deaths than any other.   The state is probably facing another 1,300 deaths this week, Covas said.   The governor has openly clashed over containment measures with far-right President Jair Bolsonaro, who claims they are needlessly wrecking the economy over a disease he has compared to a "little flu."
Date: Mon, 6 Apr 2020 22:54:10 +0200 (METDST)

Jerusalem, April 6, 2020 (AFP) - Israel will ban inter-city travel from Tuesday to Friday this week in order to forestall the spread of coronavirus during the Passover holidays, Prime Minister Benjamin Netanyahu said.    "There will be a lockdown between Tuesday from 4:00 pm (1300 GMT) until Friday at 7:00 am -- you must stay in your cities and villages," he said late Monday on television.

He also said that on Wednesday evening, when the traditional Seder meal for Passover is to be held, only people living under the same roof will be permitted to interact.     "Every family must stay at home and nobody can leave their homes between 6:00 pm on Wednesday and 7:00 am on Thursday," the prime minister added.     "The coming days will be decisive for the state of Israel," he said.    Coronavirus has so far killed 57 people in the Jewish state and infected more than 8,900, according to official figures.    Cases in Israel are concentrated heavily in the ultra-Orthodox community where health restrictions have been slow to take root, with some refusing to accept the limitations.

Netanyahu on Friday gave the green light for soldiers to be deployed in the mostly ultra-Orthodox city of Bnei Brak, which is considered the centre of Israel's novel coronavirus outbreak.   In his address on Monday, the premier pointed to "positive signs of progress" in the fight against coronavirus.   "We can envisage starting to come out of quarantine progressively after Passover, but it will depend on you," he told citizens.   Israelis are currently restricted from venturing out more than 100 metres (330 feet) from their homes, except to go to the supermarket, pharmacy or hospital.